• Title/Summary/Keyword: Cataract Surgery

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The effect of change of mandatory referral system in an ophthalmology of tertiary care medical institution (의료전달체계 변경이 3차 의료기관 안과에 미친 영향)

  • Kim, Yang-Soo;Yu, Seung-Hum;Oh, Hyohn-Joo;Kwon, Oh-Whoong
    • Korea Journal of Hospital Management
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    • v.7 no.1
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    • pp.88-104
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    • 2002
  • According to the change of mandatory referral system in July 1, 2000, the effect to the medical utilization of outpatient clinic and medical income in ophthalmology of tertiary care medical institute, S Hospital in Seoul was evaluated for 6 months before(1999. 12$\sim$2000. 5) and after(2000. 12$\sim$2001. 5). The results were as follows: 1. The number of outpatients was reduced by 16.6%. The number of patient with blindness low vision, retina, glaucoma increased and that of patient with accommodation refractive error, cataract decreased. 2. The number of cataract patients was reduced by 36.6%. The major location of patient's address was changed to nearer to the hospital. The number of cataract surgery reduced in 4.1%, the waiting time reduced in 42.2%, however surgery time increased in 20.2% and number of postoperative complications increased in 11.4%. 3. The income of outpatient clinic and cataract surgery reduced. Among items of outpatient clinic income, the most increased was ocular examination and the most reduced was injection and drugs. Among items of cataract surgery income, the most increased was operation fee and the most decreased was doctor's fee. In conclusion, for the patient, due to the lowered density of outpatient population more space was provided to the patients with more severe disease entity such as blindness' low vision, retina and glaucoma. For the hospital, the need for the expansion of ophthalmology was not found, however that for creation of the special clinics dealing with more severe disease entity was found. Due to reduced income and increased need of financial investment for the equipment and manpower for the more severe disease entity, the ophthalmology of tertiary care medical institute is faced with financial disaster. It is strongly suggested that the cost of medical practice of more severe disease entity be raised to achieve the success after change of mandatory referral system in ophthalmology.

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Analysis of Refractive Errors of the before and after Cataract Surgery by Auto-refractor (안굴절계를 이용한 백내장 수술전후의 굴절이상 분석)

  • Oh, Hyun-Jin;Jung, Mi-A
    • Journal of Convergence Society for SMB
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    • v.6 no.3
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    • pp.65-69
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    • 2016
  • We investigated refractive errors and corneal power with 3 factors such as M, $J_0$, and $J_{45}$ as power vector to find out the changes of refractive errors of the before and after cataract surgery in 119 adults aged 45~85 years with cataract. After the surgery, the 3 factors were changed as $-0.29{\pm}2.38D$ to $-0.18{\pm}0.69D$ in spherical equivalent power which is the M factor, $-0.34{\pm}0.68D$ to $-0.05{\pm}0.42D$ in the $J_0$ factor, and $0.11{\pm}0.45$ to $0.02{\pm}0.17$ in the $J_{45}$ factor. Before and after the surgery, corneal mean refractive power, $J_0$, and $J_{45}$ were changed from $44.11{\pm}1.61D$ to $44.20{\pm}1.58D$, $0.01{\pm}0.50D$ to $0.08{\pm}0.49D$, and $0.02{\pm}0.29$ to $0.08{\pm}0.49$, respectively. The results showed that $J_0$ was the highest relativeness in correlation of the pre- and post-surgery for refractive errors, mean corneal power was the highest correlation for corneal power factor, and corneal power factor was the higher correlation much more than refractive error factor.

Endophthalmitis after Removal of an Intralenticular Foreign Body in Place without Symptoms for 20 Years (20년 동안 증상없이 잔존한 수정체 내 이물제거 후 발생한 안내염)

  • Choi, Young;Eom, Youngsub;Choi, Soo Youn;Lee, Bo Young;Kim, Eun Jee;Kang, Su-Yeon;Song, Jong Suk;Kim, Hyo Myung
    • Journal of The Korean Ophthalmological Society
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    • v.60 no.5
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    • pp.480-485
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    • 2019
  • Purpose: We report a case of postoperative endophthalmitis in the cataract patient, associated with removal of an intralenticular foreign body that had remained in place without symptoms for 20 years. Case summary: A 45-year-old male visited our outpatient clinic complaining of gradual visual loss in his right eye over the past 3 months. In slit-lamp examinations, anterior capsular opacification, nuclear sclerosis, and posterior subcapsular opacity were observed in the right eye. Twenty years before, a tiny metallic projectile had hit his right eye, but slit-lamp examination at the time of injury did not reveal any intraocular foreign body. We decided to undergo cataract surgery. During phacoemulsification, a metallic foreign body was found in the lens and safely removed; then an intraocular lens was implanted. As hypopyon was evident 3 days later, we injected intravitreal antibiotics and applied fortified antibiotic eye drops to the right eye. The anterior chamber inflammation improved and the best-corrected visual acuity recovered to 1.0. Conclusions: Surgeon should be aware of that endophthalmitis could develop after cataract surgery with removal of an intralenticular foreign body that had been in place for 20 years. But did not trigger inflammation or cause any symptoms as the cataract progressed.

The Effect of Extracapsular Cataract Extraction and Posterior Chamber Lens Implantation on Intraocular Pressure (백내장적출술 및 인공수정체삽입술이 안압에 미치는 영향)

  • Cha, Soon-Cheol;Lee, Kyoo-Won
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.277-283
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    • 1994
  • We studied the change in intraocular pressure (IOP) in 15 consecutive cataract patients who underwent extracapsular cataract extraction and posterior chamber lens implantation between Feb. 1993 and Apr. 1993 to evaluate the effect of this surgery on postoperative IOP. To evaluate the clinical usefulness of non-contact tonometer, the intraocular pressures were measured with Kowa non-contact tonometer (TM-2000, Japan) as well as Goldmann applanation tonometer. There was a decrease in IOP of $3.4{\pm}2.9$mmHg (p<0.00l) 3 months after this surgery and the intraocular pressure differences between pseudophakic eyes and contralateral phakic eyes at 3 months postoperatively were $2.4{\pm}3.8$mmHg (p<0.05). The correlation coefficient between non-contact tonometer and Goldmann tonometer was 0.8876 (p=0.001) in the postoperative 76 eyes. Therefore, our results suggest that extracapsular cataract extracion and posterior chamber lens implantation alone can be a useful surgical method in cataract patient with ocular hypertension, and non-contact tonometer was relatively accurate in measuring the postoperative intraocular pressure.

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Thermographic Assessment on Temperature Change of Eye Surface in Cataract Surgery Observation (백내장수술 안에서 열화상카메라를 이용한 안구표면 온도의 변화)

  • Park, Chang Won;An, Young-Ju;Kim, Hyojin
    • The Korean Journal of Vision Science
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    • v.20 no.4
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    • pp.497-504
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    • 2018
  • Purpose : The purpose of this study was to investigate the temperature changes of the ocular surface before and after cataract surgery using thermography of a thermal imaging camera. Methods : The study included 75 patients (75 eyes) aged from 50 to 79 years who underwent cataract surgery. In the past, those who underwent corneal-related surgery, wearing contact lens, disorder of tear secretion and taking medication for systemic disease were excluded from this study. The temperature changes of the eyeball surface were measured using a thermal imager (Cox CX series, Answer, Korea) following Tear Break Up Time (TBUT) test, Mcmonnies questionnaire and Schirmer's Test in real time, Results : While the temperature of preoperative ocular surface was $35.20{\pm}0.54^{\circ}C$ and that of postoperative temperature was $35.30{\pm}0.53^{\circ}C$, the difference was not significant. The temperature changes in the ocular surface were statistically significant at $-0.12{\pm}0.08{\Delta}$ ($^{\circ}C/sec$) before the surgery and $-0.18{\pm}0.07{\Delta}$ ($^{\circ}C/sec$) after the surgery. In comparison of the age groups, it was shown that the changes in the surface temperature before the surgery were from $-0.19{\pm}0.05{\Delta}$ ($^{\circ}C/sec$) to $-0.14{\pm}0.09{\Delta}$ ($^{\circ}C/sec$) in the 50s group, and from $-0.12{\pm}0.08{\Delta}$ ($^{\circ}C/sec$) to $-0.15{\pm}0.07{\Delta}$ ($^{\circ}C/sec$) in 60s group, and $-0.18{\pm}0.07{\Delta}$ ($^{\circ}C$) to $-0.12{\pm}0.08{\Delta}/sec$) in the 70s group, showing significant changes in the ocular surface temperature at all ages. Conclusion : Following the cataract surgery, all the indicators of dry eye syndrome were decreased, and eye surface temperature changes were significant. The thermography technique of the ocular surface would be expected to be useful for the evaluation of various dry eye syndromes because it is easy to evaluate dry eye syndrome noninvasively and can be quantified.

Comparison of Intraocular Lens Power Calculation Methods Following Myopic Laser Refractive Surgery: New Options Using a Rotating Scheimpflug Camera

  • Cho, Kyuyeon;Lim, Dong Hui;Yang, Chan-min;Chung, Eui-Sang;Chung, Tae-Young
    • Korean Journal of Ophthalmology
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    • v.32 no.6
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    • pp.497-505
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    • 2018
  • Purpose: To evaluate and compare published methods of calculating intraocular lens (IOL) power following myopic laser refractive surgery. Methods: We performed a retrospective review of the medical records of 69 patients (69 eyes) who had undergone myopic laser refractive surgery previously and subsequently underwent cataract surgery at Samsung Medical Center in Seoul, South Korea from January 2010 to June 2016. None of the patients had pre-refractive surgery biometric data available. The Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug total corneal refractive power (TCRP) 3 and 4 mm (SRK-T and Haigis), Scheimpflug true net power, and Scheimpflug true refractive power (TRP) 3 mm, 4 mm, and 5 mm (SRK-T and Haigis) methods were employed. IOL power required for target refraction was back-calculated using stable post-cataract surgery manifest refraction, and implanted IOL power and formula accuracy were subsequently compared among calculation methods. Results: Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug TCRP 4 mm (Haigis), Scheimpflug true net power 4 mm (Haigis), and Scheimpflug TRP 4 mm (Haigis) formulae showed high predictability, with mean arithmetic prediction errors and standard deviations of $-0.25{\pm}0.59$, $-0.05{\pm}1.19$, $0.00{\pm}0.88$, $-0.26{\pm}1.17$, $0.00{\pm}1.09$, $-0.71{\pm}1.20$, and $0.03{\pm}1.25$ diopters, respectively. Conclusions: Visual outcomes within 1.0 diopter of target refraction were achieved in 85% of eyes using the calculation methods listed above. Haigis-L, Barrett True-K (no history), and Scheimpflug TCRP 4 mm (Haigis) and TRP 4 mm (Haigis) methods showed comparably low prediction errors, despite the absence of historical patient information.

An Index of Visual Function in Patients with Cataract - Pilot study - (백내장 환자의 시기능지표 - 사전 연구를 중심으로 -)

  • Kang, Hyung-Gon;Park, Eun-Cheol;Choi, Yoon Jung;Kim, Han Joong;Hong, Young Jai;Cho, Woo Hyun;Sohn, Myongsei;Lim, Seung Jeong
    • Quality Improvement in Health Care
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    • v.5 no.1
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    • pp.128-138
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    • 1998
  • Background : There is increased recognition that rigorous approach to functional assessment will complement the assessment of clinical status. This study is to develop the appropriate visual function index in Korean patients with cataracts by the assessment of the reliability, validity of visual function indexes including VF-14. Methods : An prospective study was performed with 92 patients who had undergone either one eye or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. Patients were interviewed. and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery process. The survey was conducted at 1-2 days before cataract surgery. Results : We used following measures : 7 visual function indexes, global measures of patients' trouble and satisfaction with vision, and best-corrected visual acuity(VA) in each eye. 7 visual function indexes showed a high internal consistency reliability (Cronbach's alpha coefficients ${\geq}$ 0.86). The better visual acuity(operated eye, better eye), the higher patient satisfaction with vision, the lower symptom score, the lower patient trouble with vision was correlated with preoperative visual function index scores. Among 7 indexes, VF-12 with the exclusion of 2 items drivings from VF-14 is a high Cronbach's alpha coefficient and correlation coefficient and the highest $R^2$. Conclusion : We conclude that VF-12 is reliable and valid in Korea. So we suggest that in Korea, all items of VF-14, the visual function index, which is in use internationally, ought to be surveyed and VF-12 which has been excluded by 2 items of drivings from VF-14 ought to be used for analysis.

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A Feature Point Tracking Method By Using Template Matching and Buffer (템플릿 매칭과 버퍼를 이용한 특징점 추적 방법)

  • Cho, Jeong-Hyun;Ahn, Cheol-Woong;Jun, Jae-Hyun
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.14 no.4
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    • pp.173-179
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    • 2014
  • Today, a surgery for cataract of Korean society frequently come to operation. A method for treating cataracts have been developed in various ways. Widely used method is a method to use the artificial lens and replace it with the existing lens. The surgery can be inserted exactly according to the angle and points that are calculated in advance in the intraocular lens insertion is important. However, The lens insertion point can delete or blur the display due to such factors as foreign material coming out of the eye during surgery. Therefore, The lens insertion point needs a method of tracking the image processing by receiving the camera images in real time display method. In this paper, we propose a feature point tracking method by using template matching and buffer. a simulation results show that our ideas can track a feature point of the intraocular lens insertion.